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小儿1型软骨鼓室成形术的结果:短期和长期听力结果的比较。

Pediatric type 1 cartilage tympanoplasty outcomes: A comparison of short and long term hearing results.

作者信息

Kaya Isa, Benzer Murat, Gode Sercan, Sahin Furkan, Bilgen Cem, Kirazli Tayfun

机构信息

Ege University School of Medicine, Otolaryngology Department, 35100, Bornova, Izmir, Turkey.

出版信息

Auris Nasus Larynx. 2018 Aug;45(4):722-727. doi: 10.1016/j.anl.2017.11.002. Epub 2017 Nov 20.

Abstract

OBJECTIVE

Tympanoplasty is a commonly used procedure in children as in adults. The purposes of this study were to evaluate and report the long term results of type 1 cartilage tympanoplasty in pediatric population. Short term and long term hearing outcomes were compared according to age and perforation location.

METHODS

We retrospectively evaluated a total of 76 of 93 patients who had regularly come to visits (38 male and 38 female) with chronic otitis media (COM) and who were younger than 16 years (range, 9-16 years) and underwent a primary type 1 tympanoplasty in tertiary medical center. We divided our population into 2 groups; a younger group (age <12 years) and an older group (age ≥12 years). Age, gender, follow-up time, prior to surgery and at postoperative 6th and minimum 48th month follow-up pure tone audiometry (PTA) thresholds and if any residual perforation were noted.

RESULTS

Successful closure occurred 74 in 76 patients and success rate was 97,03%. The mean 6th month follow-up bone conduction threshold values were 7,61±3,89 and 6,89±6,28 <12 years old and ≥12 years old children, respectively. The mean 48th month follow-up bone conduction threshold values were 6,93±4,00 and 7,12±6,40, <12 years old and ≥12 years old children, respectively. The mean 6th month follow-up air conduction threshold values were 23,75±8,38 and 24,73±10,41 <12 years old and ≥12 years old children, respectively. The mean 48th month follow-up air conduction threshold values were 17,15±6,04 and 20,30±10,30, <12 years old and ≥12 years old children, respectively. Among all children; preoperative mean air conduction differed significantly from postoperative 6th and 48th month follow-up mean air conduction thresholds (p<0.001). They had significant improvement in their ABG compared with their preoperative ABG scores. In addition according to groups, there was no significantly difference between pre and postoperative ABG improvement in both 6th and 48th month follow-up between <12 years old and ≥12 years old patient group.

CONCLUSION

In pediatric patients type 1 tympanoplasty with cartilage graft, gives statistically significant success in long term follow up. Long term hearing results of primary type 1 cartilage tympanoplasty is seem to be better than short term hearing results as well. We consider that cartilage graft could be the best graft material for pediatric tympanoplasty for long term success.

摘要

目的

鼓室成形术在儿童和成人中都是常用的手术。本研究的目的是评估并报告小儿1型软骨鼓室成形术的长期效果。根据年龄和穿孔位置比较短期和长期听力结果。

方法

我们回顾性评估了93例定期前来就诊的慢性中耳炎(COM)患者中的76例(男38例,女38例),这些患者年龄小于16岁(范围9 - 16岁),并在三级医疗中心接受了初次1型鼓室成形术。我们将研究人群分为两组;较年轻组(年龄<12岁)和较年长组(年龄≥12岁)。记录年龄、性别、随访时间、术前以及术后第6个月和至少第48个月随访时的纯音听力测定(PTA)阈值,以及是否有任何残余穿孔。

结果

76例患者中有74例成功闭合,成功率为97.03%。<12岁和≥12岁儿童术后第6个月随访时的平均骨导阈值分别为7.61±3.89和6.89±6.28。术后第48个月随访时的平均骨导阈值分别为6.93±4.00和7.12±6.40。<12岁和≥12岁儿童术后第6个月随访时的平均气导阈值分别为23.75±8.38和24.73±10.41。术后第48个月随访时的平均气导阈值分别为17.15±6.04和20.30±10.30。在所有儿童中,术前平均气导与术后第6个月和第48个月随访时的平均气导阈值有显著差异(p<0.001)。与术前ABG评分相比,他们的ABG有显著改善。此外,按组分析,<12岁和≥12岁患者组在术后第6个月和第48个月随访时,术前和术后ABG改善情况无显著差异。

结论

在小儿患者中,采用软骨移植的1型鼓室成形术在长期随访中取得了统计学上的显著成功。初次1型软骨鼓室成形术的长期听力结果似乎也优于短期听力结果。我们认为软骨移植可能是小儿鼓室成形术长期成功的最佳移植材料。

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